Locally Administered Ketorolac and Bupivacaine for Control of Postoperative Pain in LAG for Gastric Cancer: Prospective Randomized Double Blind Study

ABSTRACT

PURPOSE: The method of locally administered ketorolac and bupivacaine with epinephrine in LAG patients was examined for the control of postoperative pain. METHODS: Fifty-one patients who had undergone LAG for gastric cancer from Jan. 2005 and Aug. 2005 were enrolled in this study. All the patients were administered a fentanyl patch (25 microgram/hr) on the upper back 2 hours before the entry into the OR. Upon the completion of LAG, the patients were randomly selected for a local injection of Ketolorac and bupivacaine. Ketolorac (30 mg, 1 cc) plus 0.5% bupivacaine with 1 100,000 epinephrine (9 cc) was injected in the peritoneum and subcutaneous tissue of the mini-laparotomy wound in the study group, and normal saline (10 cc) was injected into the control group. The postoperative pain scores were assessed at 6 hr, day 1, day 2 and day 5 using a Verbal Numerical Rating Scale by a Wound Ostomy Continence Nurse. Meperidine (25 mg iv.) was used for additional analgesia. RESULTS: The frequency of additional analgesic requirement was significantly lower in the study group and the pain score was significantly lower at 6 hr postoperatively than in the control group. CONCLUSION: Locally administered ketorolac and bupivacaine with epinephrine is a simple and cost-effective technique for alleviating postoperative pain in LAG patients with gastric cancer.